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Supervised Diet - What is acceptable documentation?

lomgirl196
on 8/21/10 11:29 am
I did two supervised diet programs but I'm concerned my documentation isn't good enough for insurance approval. 

My first dr supervised diet was from a hospital which inluded calorie restriction (800 primarily shakes) and weekly meetings with weigh ins, and planned goals for exercise.  I have three letters from this dr/hospital diet program which was sent to my primary care physician outlining my attendance, goals, start and progress, and the letters span over/past a 6 month period, but I do not have my weekly weigh in logs.  Silly me I threw out my weekly weigh in logs and I did this purpously because I had lost weight and never wanted to see these weight numbers again.  Obviously I was not thinking of bariatric surgery at this time.  Unfortunaltey it took me all  but two years to gain back all the weight I had lost.

My second supervised diet was from my primary care physician PCP, and I have copies of pharmacy records that indicate I was on Adipex (diet pill) for 10 months.  I did see my PCP various times throughout this process but not monthly.  I also did Weigh****chers during this time but I have looked everywhere and I cannot find my weekly logs from WW.  I do have documentation regarding my registration into two - 12 week WW programs but not my weekly logs.    

What do you think?  Will this suffice?  What have others used for approval and or appeals?
poet_kelly
on 8/21/10 11:31 am - OH
I would check with you insurance company.  Different companies may have different requirements.

Kelly
Carebearny1999
on 8/21/10 11:46 am - Rochester, NY
I just had to list what I had tried and have my PCP sign it
yowala
on 8/21/10 12:44 pm - Houston, TX
My insurance company wouldn't accept the Weigh****chers book because there was no proof that I didn't just write in the weights myself.  Every time you see your doctor don't they weigh you?  My insurance company wanted those records more than anything.  Most insurance companies have their guidelines for weight loss surgery on their website.  You may have to look under the provider section instead of the insured member section.  Might be listed under something called "medical policies" or "benefit guidelines."
I'm on my way!                        
Jessica S.
on 8/21/10 1:21 pm
I know every insurance company is different in what they want.  Mine needed specific info every time i went to the doctor - bmi, weight, blood pressure, height, etc.  And they required it in a specific form... Your insurance company will tell you exactly what they need...

yasulh
on 8/21/10 4:01 pm - Augusta, GA
You definitely need to talk with your insurance company and find out their requirements. My insurance company requires that I send the progress notes from six consecutive monthly diet visits with my doctor and the notes have to include certain things. A summary letter is not acceptable for them, and I can't have missed any months.